This is an overview of medical education today. It deals with tertiary education matters pertinent to medical schools in South Africa, the forces that will inevitably cause medical education to change and the responses of other countries to similar circumstances. These forces are medical, educational and political. The medical forces bringing about changes are concerned with the explosion in knowledge in the fields of medical facts, technologies, therapies and informatics. It is an ongoing educational problem as to how the burgeoning sciences can be balanced with the present call for the return to the humanities. Medical schools are being required, through their teaching and learning methodologies, to encourage the qualification of empathetic graduates with generalist (holistic) skills and attitudes to best serve their patients. Educational forces, in particular new curriculum strategies, will need to be explored to assist teachers and students to cope with the demands of communities and individuals for care with expertise. In many First World countries these demands have found expression in moves from Traditional to Innovative curricula. Fundamentally, Traditional schools teach normal Anatomy and Physiology first, then move to the abnormal, before students reach the Clinical Years where these "basic sciences" are applied. Innovative schools, on the other hand, employ Problem-Based Learning with Community-Orientation throughout their curricula, with early patient contact, horizontal and vertical integration of disciplines, group work and community interaction as crucial aspects of their students' learning. Supporters of the Innovative philosophy see as progressive the revising of Flexnerian notions of basic science building blocks, the debalkanising of instruction subject by subject and the motivational impetus achieved when learning takes place in context. Political factors can impinge on staff teaching and student learning by Governmental demands through statutory councils or through the power exerted by the universities. Macro politics dictate financial or other resources that are allocated and may in future directly influence what sort of doctor the various medical schools are expected to graduate. The politics of staffing the teaching institutions, the development of teachers, and the demographics of the student population raise important questions of direction and commitment, and may lead to new realignments. The recognition of the importance of teaching at a professional level is a crucial factor in educating students more appropriately. Teachers versed in the medical pedagogic process will be pivotal in producing a new breed of doctors. This new breed will not be expected to "know everything" but have a core knowledge carefully ascertained by each medical faculty and the ability to find information that is further required. Students will not be expected to acquire all the facts to sustain them through the rest of their professional lives, but to have enquiring minds and the motivation to continue their education, to satisfy their curiosity and provide improved patient care. Their skills in mastery of the behavioural sciences will be more pertinent than ever as preventative medicine becomes as important as curative. They will be expected to formulate ethical attitudes and provide leadership in community and individual dilemmas. These are challenges that will need to be faced critically by our medical teachers who are too often experts in content in ever-narrower sub-specialities. For these challenges to be met, teaching cannot be taken for granted, but must be viewed more seriously by the schools and changes made where appropriate. The University of Cape Town (UCT) has a considerable reputation in the quality of its medical graduates. However, for its medical faculty to remain in the forefront of medical education, it needs to reconsider the knowledge required, the skills and attitudes embodied in its graduates but, as importantly, it must take the lead in undergraduate training. The need for renewing strategies and the action required are the themes of this dissertation.

A thesis submitted to the Faculty of Health Sciences University of the Witwatersrand Johannesburg in fulfilment of the requirements for the degree of Doctor of Philosophy October 2015 / This study investigated students’ experiences of integration of learning in the undergraduate medical programme at the University of the Witwatersrand. There is evidence that integration of learning, also referred to as “integrative learning”, assists students to assimilate and apply what they have learnt more effectively, and thus enhances the goal of achieving professional competence. From 2003, Years 3 and 4 of the undergraduate programme were redesigned to be presented as integrated system-based blocks, using problem-based learning as the main learning strategy. From 2005, Years 5 and 6 were also redesigned. Although clinical rotations in specific disciplines still formed the main learning strategy, a number of integrating activities – and even rotations – were included in the new programme in these years. From 2006 Years 1 and 2 of the programme (which were still discipline-based) were reviewed in terms of course content and integration of learning, and new courses were added to those years to facilitate integration of learning. As a result of the reforms outlined above, the six years of the undergraduate medical programme at the University of the Witwatersrand now contain a rich variety of features designed to advance integration of learning. However, the ways in which students and teachers experience these kinds of integration are not known, neither is the effect that they are having on student learning. Investigating student and teacher experiences of a variety of events designed to promote integration of learning deepens the understanding of the many and varied effects of such integration activities, and contributes to the body of knowledge on integration of curricula in medical education. This study also contributes to a generic understanding of the phenomenon of integration in the process of learning, potentially enhancing knowledge and practice in the field of medical education. This is a qualitative study which used phenomenography, a research approach with an educational interest. The phenomenon of integration of learning is one which exists in the understanding of persons involved in the learning process, as teachers or students and, for this reason, an approach which clarifies that understanding was followed. The principal sampling approach was purposive. Data collection spanned 27 months (March 2012 to June 2014) and a total sample of 25 students and 10 teachers were the respondents, providing information through in-depth interviews and small focus group discussions. The semi-structured interviews were conducted using a tool that introduced an entry question such as “What is your understanding of ……?” Subsequent dialogue followed on angles of responses, leading to the development of different categories of how the phenomenon is experienced. Interviews were recorded using a voice recorder. Focus group discussions and further individual interviews were used to refine ideas and not necessarily to increase the size of the original sample. For analysis, the researcher used qualitative data analysis software, MAXQDA11. Excerpts that conveyed the most significant information were selected, de-contextualised and compared, followed by grouping and re-grouping of them until the outcome space was formulated. Three categories of description made up the outcome space. The categories that emerged represent the qualitatively different experiences of the students and teachers who were interviewed: conceptions of meaning and processes of integration of learning; conceptions of how to integrate learning and development of integration ability; and conceptions of the links between integration ability and educational experiences. The outcome space was constituted using as a guide the framework of the anatomy of awareness and the structure of experience as espoused by Marton and Booth (1997). The lowest level of conception is that integration of learning is a vague and abstract concept which happens passively while an ability to integrate learning is conceived of as an atomistic acquisition of fragmented facts. The respective act of learning is experienced as knowledge increase. A conception of increasing appreciation of the phenomenon is that it is important to consciously link concepts through identifying essential detail. This is a perception of higher value as it includes the ability to remember everything. A conception of higher value is that subjects are related as they contribute to each other. Understanding one leads to the understanding of another. The concept of integrative learning is introduced and this happens during studying. The most sophisticated conception is that integration of learning happens automatically as students accumulate knowledge and experience. Integration of learning, therefore, becomes a way of thinking, an unconscious competence for life in an integrated career. Students adopt strategies that enable learning for meaning while drawing on all knowledge and skills. When the outcome space is translated graphically, a model of how students develop the ability to integrate learning is revealed. From the model, it was apparent that students embark on a journey of integration of learning through taking steps that increase in complexity and hierarchical inclusivity. The integration of learning takes a relatively long time to develop, occurring from the first year to the sixth year, but starting from minimal to highly complex acts of learning, to be able to cope in a complex career in a complex world. The affective constructs towards the phenomenon also change over the years from negative to positive. All this happens in an environment that is regulated by affective constructs and motivation factors. The acquisition of the ability to integrate learning is conceived to take long depending on the effects of affective constructs and the external horizon. From the model, four factors emerge that are critical for integration of learning in that they either promote it or prevent it from occurring effectively. The factors can be grouped according to whether they involve the teacher, curriculum, student and studying. Recommendations for application of the model were drawn around interventions that impact on improvements specific to each of the factors identified. This is a proposed developmental model which is a logical presentation of integration of learning. The proposed model requires additional research to provide further empirical justification. Gibbs (1994) refers to a proposition that research on student learning has something substantial to feed back into the context within which it is undertaken. The researcher makes specific reference to Harden’s (2000) integration ladder as a benchmark for curriculum integration strategies that strengthen integration of learning in institutions of Higher Education. KEYWORDS Integration of learning Integrative learning Curriculum integration Phenomenographic research into integrative learning Learning approaches 21st century learning theories Learning according to phenomenography Pedagogies of integration of learning Anatomy of awareness

Thesis (M.A.)--University of Chicago, 1937. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (M.A.)--University of Chicago, 1937. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--Drexel University, 2005. / Includes abstract and vita. Includes bibliographical references (leaves 121-124).

Thesis (Ph. D.)--Virginia Commonwealth University, 2006. / Prepared for: Dept. of Physical Therapy. Bibliography: leaves 139-151. Also available online.

<p> The purpose of this study was to develop an assessment tool to measure musical training and experiences for grouping participants in human neuroimaging research studies. To fulfill the purpose of this study, the researcher: 1. Completed a comprehensive review of the research literature to establish the essential content of the assessment tool; 2. Developed an assessment tool to survey subjects about their musical training and experiences; 3. Pilot tested the assessment tool, and revised the tool according to the preliminary analyses of the validity, reliability, and usefulness of the assessment tool; 4. Established the content validity and reliability of the assessment tool with subjects participating in a neuroimaging study designed to analyze the influences of musical training and experiences on brain structures and functions, and 5. Determined if the assessment tool function effectively in the selection and grouping of musically and musically untrained subjects for neuroimaging studies. </p><p> The assessment tool was administered to a purposive sample (<i> N</i> = 42) in the southeastern region of the United States. Participants were recruited on the basis of musical training, both the existence and lack thereof. The assessment was completed via the web-based platform, Qualtrics. Coding of survey responses indicated differences in the participant pool that resulted in two groups: Musicians and Non-musicians. Further investigation yielded two subgroups within the Musician participant group: Moderate and Advanced. </p><p> Validity of the assessment tool was established using a three-step construction process, (a) development of a draft based on the existing literature and the musical training knowledge of the researcher, (b) a review of the assessment tool by five music educators and performers, and (c) administration to a pilot group of five additional people with varying levels of musicianship. Additional content validity was completed by external reviewers by rating each assessment item using a Likert-type scale: 1&ndash;<i>Not important </i>, 2&ndash;<i>Slightly important</i>, 3&ndash;<i>Fairly important</i>, 4&ndash;<i>Important</i>, and 5&ndash;<i> Very important</i>. Reliability was established using interrater reliability and was determined to be 88.9%. </p><p> A discussion was presented that included the differences among participants that made their musical training and experiences unique compared with other participants. Implications were discussed regarding the usage possibilities for the survey, as well as the potential effects of the survey on human neuroimaging research.</p><p>

It is important for doctors to be clinically competent and this clinical competence is influenced by their clinical reasoning ability. Most research in this area has focussed on clinical reasoning ability measured in a problem - solving context. For this study, clinical reasoning is described as the process of working through a clinical problem which is distinct from a clinical problem solving approach that focuses more on the outcome of a correct diagnosis. Although the research literature into clinical problem solving and clinical reasoning is extensive, little is known about how undergraduate medical students develop their clinical reasoning ability. Evidence to support the validity of existing measures of undergraduate medical student clinical reasoning is limited. In order better to train medical students to become competent doctors, further investigation into the development of clinical reasoning and its measurement is necessary. Therefore, this study explored the development of medical students' clinical reasoning ability as they progressed through the first two years of a student - directed undergraduate problem - based learning ( PBL ) program. The relationships between clinical reasoning, knowledge base, critical thinking ability and learning approach were also explored. Instruments to measure clinical reasoning and critical thinking ability were developed, validated and used to collect data. This study used both qualitative and quantitative approaches to investigate the development of students' clinical reasoning ability over the first two years of the undergraduate medical program, and the factors that may impact upon this process. 113 students participated in this two - year study and a subset sample ( N = 5 ) was investigated intensively as part of the longtitudinal qualitative research. The clinical reasoning instrument had good internal consistency ( Cronbach alpha coefficient 0.94 for N = 145 ), inter - rater reliability ( r = 0.84, p < 0.05 ), and intrarater reliability ( r = 0.81, p < 0.01 ) when used with undergraduate medical students. When the instrument designed to measure critical thinking ability was tested with two consecutive first year medical student cohorts ( N = 129, N = 104 ) and one first year science student cohort ( N = 92 ), the Cronbach Alpha coefficient was 0.23, 0.45 and 0.67 respectively. Students ' scores for clinical reasoning ability on the instrument designed as part of this research were consistent with the qualitative data reported in the case studies. The relationships between clinical reasoning, critical thinking ability, and approach to learning as measured through the instruments were unable to be defined. However, knowledge level and the ability to apply this knowledge did correlate with clinical reasoning ability. Five student - related factors extrapolated from the case study data that influenced the development of clinical reasoning were ( 1 ) reflecting upon the modeling of clinical reasoning, ( 2 ) practising clinical reasoning, ( 3 ) critical thinking about clinical reasoning, ( 4 ) acquiring knowledge for clinical reasoning and ( 5 ) the approach to learning for clinical reasoning. This study explored students' clinical reasoning development over only the first two years of medical school. Using the clinical reasoning instrument with students in later years of the medical program could validate this instrument further. The tool used to measure students' critical thinking ability had some psychometric weaknesses and more work is needed to develop and validate a critical thinking instrument for the medical program context. This study has identified factors contributing to clinical reasoning ability development, but further investigation is necessary to explore how and to what extent factors identified in this study and other qualities impact on the development of reasoning, and the implications this has for medical training. / Thesis (Ph.D.)-- Medicine Learning and Teaching Unit, 2006.

The lecturer practitioner role in nursing is widely seen as offering hope for the future of nurse education, by overcoming the 'theory-practice gap', and establishing and maintaining effective links at many different levels between education and practice. It is clear, however, that there are a number of issues of concern about the role. These can be summarised as: lack of role clarity about overcoming the theory-practice gap; varying conceptions of the role and unclear job descriptions; and role conflicts and overload, from the conflicting demands of service and education settings Despite current political support for strengthening the links between higher education institutions and practice settings, a new governmental emphasis on the support of students in practice, and a growing in-depth evaluative literature about the role, there is no research examining its systematic development, or measuring and addressing aspects of lecturer practitioners' occupational stress and burnout. Initial project planning work found that lecturer practitioners perceived themselves as 'adding value' to education provision, with personal and professional gains for postholders. However, their key concerns were: absence of role clarity; absence of effective joint review/appraisal;a bsenceo f formal support In, order to develop and address aspects of lecturer practitioners' work roles and their employment position, this action research project was established. Using a spiral methodological framework, and a multi-methods approach to data collection to triangulate the findings, new knowledge about lecturer practitioner roles was uncovered, and employment practices were developed as a result. The project established three new mechanisms, and these outcomes can be summarised as: joint appraisal policies and materials; orientation/induction policies and materials; group support network. In addition, previously validated measures of occupational stress and burnout were used to meas. ure those conceptsi n this group of lecturer practitioners, and the impact of the project. They were found to be generally no more stressed or burnt out than comparable workers, and the project was unable to demonstrate statistically significant differences in beforeand after-scores. Synthesis of quantitative and qualitative findings indicates that these LPs were 'thriving rather than just surviving'.

Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 4 uppsatser.